The primary endpoint of this study is to determine whether cycles of short term FMD exposure to a fasting-mimicking diet is effective in reducing total cholesterol levels.

the short term FMD exposure to a fasting-mimicking diet reduce total cholesterol levels

Inclusion Criteria:

• Age ≥ 18 years
• WHO performance status score 0-2
• Early stage breast cancer, ER positive, receiving an adjuvant endocrine treatment with aromatase inhibitor
• Hypercholesterolemic (total cholesterol >200mg/dL)
• Ongoing treatment with aromatase inhibitors (at least six months of drug exposure)
• Adequate renal, hepatic, and hematopoietic function
• Written and informed consent for biomaterial submission and participation in the clinical trial
• Compliance with treatment and follow up protocol
• No other investigational agent may be administered concurrently to patients enrolled in this trial
• Patients with skeletal pain are eligible if bone scan and/or RX examination fails to disclose metastatic disease
• The interval between the onset of systemic adjuvant therapy with AIs and the randomization should be at least 6 months
• Patient is accessible geographically for follow-up and must be able to provide dietary data via telephone recalls
• Must be medically able to accept either dietary supplementation group prior to randomization.

Exclusion Criteria:

• Underweight (BMI < 18.5 kg/m2)
• Current or past eating disorders identified with the SCOFF Questionnaire (Useful Eating Disorder screening questions) [19]
• Malnutrition Universal Screening Tool (MUST). It considers body mass index, weight change and acute disease effect equally and determines a malnutrition risk score. A score ≥1 identify a patient at moderate risk of malnutrition;
• Treatment with any investigational or non-registered drug other than the study product(s) within 30 days preceding the first dose of study product, or planned use during the study period
• Use of statins or supplements similar to statins (e.g red rice) or other drugs that interfere with lipid absorption (e.g ezetimibe)
• Known to have difficult-to-control hypertension, coronary artery disease, arrhythmia requiring treatment, clinically significant valvular disease, cardiomegaly on chest X-ray, ventricular hypertrophy on ECG, previous myocardial infarction, or congestive heart failure Patients with diabetes are not eligible for the study
• History of allergic reactions likely to be exacerbated by any component of the investigational product used in the study
• Other concurrent, severe medical problems, unrelated to the malignancy, that would significantly limit full compliance with the study or expose the patient to unacceptable risk
• Previous or concomitant malignancies at other sites, except effectively treated malignancy that is considered by the Investigator to have been cured
• Psychiatric or addictive disorders that may compromise the ability to give informed consent or to comply with study procedures.

only female